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Is clinical neurology really so difficult?
  1. F Schon1,
  2. P Hart2,
  3. C Fernandez3
  1. 1Neurology Department, Atkinson Morley's Hospital, Copse Hill, London SW20 0NE, UK
  2. 2Neurology Department, Royal Free Hospital, Pond Street, London NW3
  3. 3Audit Department, Mayday Hospital, Thornton Heath, Surrey CRO 77YE, UK
  1. Correspondence to:
 Dr F Schon

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Neurosciences need to be made more accessible for medical students

Neurology, it seems, has a reputation among medical specialties of being particularly difficult. This was highlighted in the British Medical Journal in 19991 when the editor wrote, “the neurologist is one of the great archetypes: a brilliant, forgetful man with a bulging cranium....who....talks with ease about bits of the brain you'd forgotten existed, adores diagnosis and rare syndromes, and—most importantly—never bothers about treatment.” The relevance of this view to the teaching of neurology was analysed in a not totally serious letter in 1994 by Ralph Jozefowicz2 entitled “Neurophobia,” in which the author claimed 50% of medical students at some stage have “ a fear of neural sciences and clinical neurology.” His explanation for this was students' inability to apply knowledge of basic sciences to the clinical situation. This letter was based on personal views not supported by what the BMJ called “evidence based education” in another editorial in 1999.3 We therefore set out to ascertain perceptions of seven major medical specialties among British medical students, senior house officers (SHOs), and general practitioners, principally in order to find out the actual perceptions of neurology in comparison with the other disciplines.

THE STUDY

Part 1

Part 1 was a questionnaire based study, given to four separate groups and the results presented are the analysis of 345 replies: 101 medical students from St George's Hospital (five sequential groups of about 20 at the end of their fourth year clinical neurology attachment), 85 medical students from the Royal Free Hospital attending a revision course for their final examinations (the total size of this group was 94), 100 SHOs attending teaching courses for parts 1 and 2 of the MRCP examination (of a total of 108), and 59 general practitioners (31of whom were attending a postgraduate …

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